Thursday, October 22, 2020

Some good news?

The death rate from COVID-19 may be lowering. Two new peer-reviewed studies show a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions. One study in New York looked at 5,000 hospitalized patients, a second looked at 21,000 in England.

The NY study found that mortality dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance, which is still very high. The England study also found a similarly sharp drop in the death rate.

Obviously, there is a possibility that the rates were lower because, as one researcher says, "The people who are getting hospitalized now tend to be much younger, tend to have fewer other diseases and tend to be less frail than people who were hospitalized in the early days of the epidemic." 

But the studies were adjusted for factors including race, age and other diseases, such as diabetes, to rule out the possibility that the numbers had dropped only because younger, healthier people were getting diagnosed. They found that death rates dropped for all groups, even older patients by 18 percentage points on average. 

The researchers don’t think that there is one reason for the decline. There are many factors. 

For example, the data strongly suggest that keeping hospitals below their maximum capacity also helps to increase survival rates. When cases surge and hospitals fill up, "staff are stretched, mistakes are made, it's no one's fault — it's that the system isn't built to operate near 100%," he says. 

Doctors have gotten better at quickly recognizing when COVID-19 patients are at risk of experiencing blood clots or debilitating "cytokine storms," where the body's immune system turns on itself. This “makes it much easier to deal with the complications that occur because you already have protocols in place." 

Doctors have developed standardized treatments that have been promulgated by groups such as the Infectious Diseases Society of America. 

The researchers believe that mask-wearing may be helping by reducing the initial dose of virus a person receives, thereby lessening the overall severity of illness for many patients.

This sounds good. But the lowered rate of 7.6% dying is still very high. As one researcher says, "A lot of my patients are still complaining of shortness of breath," she says. "Some of them have persistent changes on their CT scans and impacts on their lung functions."

Here's something you always wanted to know



Courtesy of our Florida correspondent

Dancing Doctor